The Death of Amy Winehouse and the Failure of Rehab

It's incredibly sad that Amy Winehouse didn't live to see her 30th birthday. Some people are saying that it was inevitable she'd die from her addiction, and while I'm not surprised by this defeatist attitude, I think it's terribly wrong-headed.

The generalized pessimism that exists today regarding those who abuse drugs is related, I believe, to the dearth of viable, long-term solutions to the challenge of drug abuse, or for that matter, to the general problem of addiction.

As a psychiatrist who specializes in treating addictions, I've seen the limitations of the current approach. The all too familiar "revolving door" or "seesaw" patterns seen with rehab and weight-loss programs are not a demonstration of the weakness of human nature as much as an indication of the way these programs repeatedly fail the addict. The answer doesn't lie in the application of willpower, but in understanding the true nature of addiction.

Not that many years ago I worked at a hospital-based, 12-step oriented program where a good number of the clients were mandated to attend by the courts. I saw how at best, the clientèle was ambivalent about being there and at worst simply marking their days until they'd fulfilled their mandate.

Every last soul in the program had a significant trauma history, but this was glossed over in favor of plodding through each of the precious steps, most of which were incomprehensible or irrelevant to this population.

Those of us who study and treat addiction are rigidly attached to a tired old methodology, despite its obvious shortcomings. No wonder we feel hopeless. I don't know if it's a failure of our collective imagination or the greed of the program directors that's responsible for the rut we find ourselves in, but until we let go of our "addiction" to this outmoded solution, our pessimism will persist.

People suffering from addiction, including artists like Amy Winehouse, need to be seen not as "sick" individuals who'll inevitably succumb to their "disease" but as those who are using their addiction for a specific, if unconscious purpose.

We talk about the subject all the time but do we really know what it means to be "an addict?" In my mind, a person is addicted to something when they're convinced they can't do without it, they're unable to resist it, they can't walk away from it, and it's meeting some deep needs.

I see a common thread in all addictive behaviour: the compulsion to address unhealed childhood emotional wounds (from loss, trauma or betrayal) and unmet emotional needs (from neglect, abandonment or poor attachment).

Many addicts have more than one addiction, and I've treated people who were simultaneously struggling with cocaine, alcohol, and food addictions, or with marijuana and video gaming. Also, addictions are transferable. This has been demonstrated by the recent phenomenon whereby people who've had gastric bypass surgery then began to abuse alcohol, spend compulsively or gamble.

The existence of addiction transference and multiple addictions demonstrates to me that addictions are interchangeable, and for this reason, all rooted in the same fundamental psychological drive for healing and nurturing. This is also why they require a form of treatment that addresses this root cause.

While I can't claim to know anything about the particular case of Ms. Winehouse, I can say from long experience working with creative types that artists are particularly challenging to treat. This is because for them, addiction is an off-shoot of their ecstatic personality type.

Artists crave the transcendent experience which alcohol, drugs, spending or even sex can bring them. For this group, the answer to addiction lies in learning the joys of balance and grounding, and in seeing that they can achieve transcendence in the absence of intoxication.

Addiction is a false solution to a real problem. No amount of food, drugs, exercise or gambling will do the trick. In the addict's mind, however, there exists a "pathological hope," a false conviction that eventually, if they just keep at it, they'll find fulfillment and relief.

In a sense, those of us who treat addiction are imbued with the same pathological hope of success. We're convinced that if we continue with our flawed solutions that eventually, they'll succeed.

The abstinence model is a bust. It doesn't address what we should do with substances (like food) that we can't completely give up. Also, if a person is dealing with emotional deprivation, avoiding what they imagine to be the source of their healing and nurturing will eventually prove intolerable. This, I believe, is the reason why people constantly "fall off the wagon" when they use the 12-step approach.

Instead of demanding that the addict abstain from food, drugs, alcohol or cigarettes, we can help them see that these are a "false fix" to their real needs and learn what it is they really need and how they can have it. If they can replace the food, let's say, with self-love or the drugs with self-soothing, they'll more easily be able to give up their addiction.

I employ a four-pronged approach to the treatment of addiction: the addict works on developing self-acceptance and self-care; they face the wounds of their past, grieve their losses and release their anger; they identify and combat their negative self-talk and distance themselves from those who undermine their progress and finally, they learn what real fulfillment is.

Amy Winehouse couldn't be saved, but for all the other addicts out there today there is hope. This is only posible, though, if we're willing to let go of the way we've been dealing with addiction and adopt a fresh approach.